The SANE is one of the simplest patient-reported outcome measures available, capturing joint function in a single question. This page explains what the SANE is, what it measures, how it is administered, how it is scored, and how it is used.
What is the SANE score?
The SANE (Single Assessment Numeric Evaluation) is a single-item, patient-reported outcome measure in which a patient rates the function of an affected joint or body region as a percentage of normal. It has gained popularity as a low-burden way to capture patient-perceived function and has been applied to the knee, shoulder, ankle, and other regions, including after joint replacement and sports injuries.
What does the SANE measure?
The SANE measures a patient's overall perception of how normal an affected joint or region feels, expressed as a single percentage. Because it asks for a global self-rating rather than dissecting individual symptoms and activities, it provides a quick snapshot of perceived function and recovery.
What question is included in the SANE?
The SANE consists of one question, typically phrased as: "How would you rate your affected [joint or body part] today as a percentage of normal, where 0% is completely abnormal and 100% is normal?" The specific region is named so that responses stay consistent across visits, which is especially important for patients with bilateral or multiple painful areas.
How is the SANE scored?
The patient provides a single number from 0 to 100, where 0 represents completely abnormal function and 100 represents normal function; higher scores indicate better function. There is no calculation or conversion step, and the score is used directly and tracked over time.
How is the SANE used in clinical practice?
The SANE is used to capture perceived function at intake and at follow-up, and it fits easily into high-volume workflows and remote monitoring because it takes only moments to complete. Research has shown reasonable to strong correlation between the SANE and longer, multi-item PROMs, which supports its use as an efficient proxy when clinician or patient time is limited.
Strengths and limitations
Strengths include extreme brevity, low respondent burden, avoidance of survey fatigue, and good correlation with more detailed measures. Limitations include less granularity than multi-item instruments, potential variation in how patients interpret "normal," and greater sensitivity to phrasing, so consistent wording and clear identification of the body region are important. It is often used together with a condition-specific PROM for a fuller picture.
Frequently asked questions
How many questions are on the SANE? Just one: the patient rates the affected region as a percentage of normal.
What does a SANE score of 100 mean? It means the patient perceives the joint or region as completely normal.
Is the SANE reliable compared with longer PROMs? Studies report reasonable to strong correlation between the SANE and multi-item measures, supporting its use as an efficient outcome measure.
References
- Williams GN, Gangel TJ, Arciero RA, Uhorchak JM, Taylor DC. Comparison of the Single Assessment Numeric Evaluation method and two shoulder rating scales. American Journal of Sports Medicine. 1999;27(2):214-221.
- Shelbourne KD, Barnes AF, Gray T. Correlation of a single assessment numeric evaluation (SANE) rating with modified Cincinnati knee rating system and IKDC subjective total scores. American Journal of Sports Medicine. 2012;40(11):2487-2491.
- Gowd AK, Charles MD, Liu JN, et al. Single Assessment Numeric Evaluation (SANE) is a reliable metric to measure clinically significant improvements following shoulder surgery. Journal of Shoulder and Elbow Surgery. 2019;28(11):2238-2246.
